The following articles and studies support the need for improved low vision services in the area of post-acute care:

Aging and vision loss fact sheet from the American Foundation for the Blind:

  • 6.5 million Americans live with vision loss.  This is expected to double by 2030.
  • The risk of low vision and blindness increases significantly with age.
  • Vision loss can adversely impact the overall health and well-being of older adults in many ways:
    – Increased risk of falls and fractures
    – Increased risk of depression
    – Difficulty identifying medications
    – Difficulty bathing, dressing, and walking around the house.

Visual Impairment and Blindness in Adults in the United States: Demographic and Geographic Variations from 2015 to 2050“:

  • The number of older Americans with visual impairment or blindness is expected to double by 2050.
  • Uncorrected refractive errors impact 8.2 million people.
  • Vision rehabilitation services can help individuals regain self-sufficiency and improve quality of life.

Age Related Eye Disease” from the National Eye Institute:

  • As the average lifespan of the population increases, the population living with age-related macular degeneration (AMD) is expected to increase dramatically.
  • 1.7 million people have AMD.  100,000 are blind as a result.

(This study focused primarily on potential treatments for the disease.  There is currently no cure.)

Low Vision Rehabilitation in a Nursing Home Population: The SEEING Study”.

  • Patients in nursing homes with low vision are typically pushed in wheelchairs for convenience.
  • Too much assistance is given for independent living skills (such as eating) to speed up the task.
  • Nursing homes don’t have adequate staff to help patients who have low vision.
  • Training of nursing home staff to improve the living environment is recommended.

(This study from Johns Hopkins is probably the most significant research conducted in this area.)

The relationship between sensory impairment and functional independence among elderly

  • A significantly greater proportion of residents with low vision than of those with good vision were dependent on caregivers for performing activities of daily living.

Vision Rehabilitation for Elderly Individuals with Vision Loss or Blindness”:

  • Individuals with low vision experience significant improvements in quality of life following exposure to comprehensive vision rehabilitation programs.
  • Significant improvements from baseline were seen across four subscales: low vision, living skills, manual skills, and orientation and mobility skills.

(Skills listed in this study are the primary focus areas for low vision therapy, which is lacking in most post-acute settings.)

Vision Rehabilitation: Care and Benefit Plan Models: Literature review

This includes articles with a focus on the psycho-social aspects of visual impairment on those in post-acute care.

Long-Term Care Providers and Services Users in the United States: Data From the National Study of Long-Term Care Providers, 2013-2014

1.4 million Americans are residents in nursing homes with a total of 1.7 million available beds in 2014.

Managing post-acute care in the 21st Century

About 20% of patients are discharged to post-acute care annually.  Hospitals are incentivized to reduce readmissions for patients by improving programs in post-acute care.

Background on Post-Acute Quality Initiatives

This CMS announcement shows the changes in requirements for the IMPACT Act in 2018, including an emphasis on improved mobility in post-acute care.